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Medical problems of performing artists
Musicians as an occupational group are exposed to various ergonomic exposures which may lead to musculoskeletal problems. In this study we assessed the frequency of musculoskeletal disorders (MSDs) among Iranian instrumentalists (using traditional Iranian and western instruments). In a cross-sectional study we assessed the frequency of MSDs in 356 Iranian instrumentalists by standardized Nordic musculoskeletal questionnaire according to age group, type of instrument, duration of playing, and playing/sitting position. Data were analyzed using chi-squared, t-test and ANOVA. Overall, 158 of 356 subjects (44.4%) experienced MSDs, mostly with mild or moderate symptoms. Frequency of MSDs was significantly higher in females but it was not significantly related to body mass index, duration of employment, and duration of playing or teaching. Our study showed a high frequency of MSDs among Iranian instrumentalists, so paying attention to the ergonomic exposures of instrumentalists as an occup...
Annals of Medical Research, 2019
The study aimed to evaluate work-related musculoskeletal disorders and ergonomic risk levels in instrumentalist musicians. Material and Methods: This is a cross-sectional study. The present study consists of 46 musicians, including 11 violinists, 11 side flutists, 13 pianists and 11 baglama players between the ages of 18 and 50 years who are play at least one of the instruments. The socio-demographic characteristics of the musicians and the data of instrument were questioned by using a descriptive questionnaire. The Quick Exposure Check method was used to analyze the ergonomic risk and Expanded Nordic Musculoskeletal System Questionnaire was used to question musculoskeletal diseases. Results: 48.2% of the participants were male and 52.8% were female. 79.3% of all participants had a daily instrument playing time more than 2 hours. Only 9.6% of the musicians had a low level of ergonomic risk. The most common musculoskeletal problems were seen on the wrist, neck and shoulders. The ergonomic risk levels of the musicians who reported pain were also high. Ergonomic risk levels were significantly higher in musicians who reported low back pain and hip-thigh pain (p <0.05). There was a significant difference between the musical instrument types and ergonomic risk levels of musicians, and it was found that the level of ergonomic risk was higher among piano and violin users (p <0.05). Conclusion: In our study, the ergonomic risk levels and the incidence of musculoskeletal disorders related to work of musicians were found to be remarkably high. For this reason, preventive rehabilitation studies should be conducted in musicians. We think that our study will shed light on intervention research in which ergonomic risk management is planned.
https://www.ijhsr.org/IJHSR_Vol.11_Issue.12_Dec2021/IJHSR-Abstract.017.html, 2021
Musicians performing over an instrument demands repetitive, awkward postures and postural stress from prolonged sitting or standing. Musicians are found to be more prone to the development of Playing-Related Musculoskeletal Disorders (PRMDs) due to these factors. PRMDs are defined as 'pain, weakness, numbness, tingling or other symptoms that interfere with their ability to play an instrument'. There is an increasing interest seen in the medical issues faced by the musicians performing over an instrument. There are different type of musicians playing different instruments which means different instrumentalists face different musculoskeletal disorders depending upon many factors. There are intrinsic and extrinsic factors involved which contribute to the development of PRMDs in musicians. Development of PRMDs is seen to be a cause of early termination of musician's career. The purpose of study is to review the epidemiology of musculoskeletal disorders in musicians.
Occupational Medicine, 2011
Background Musculoskeletal disorders in humans may originate from biomechanical, environmental, psychosocial and personal risk factors encountered in the working environment. These disorders in musicians are designated as playing related musculoskeletal disorders (PRMD). To investigate the correlation between biomechanical, environmental, psychosocial and personal risk factors and potential incidence of PRMD arising in professional classical musicians. Fifty-nine orchestral classical musicians were observed: They also filled out questionnaires providing information regarding musculoskeletal symptoms, psychosocial factors and demography. Clinical observation using the Rapid Upper Limb Assessment (RULA) showed significantly higher scores in string musicians compared with woodwind and brass players (right RULA score F 5 4.77, P , 0.05; left RULA score, F 5 3.90, P , 0.05). A multivariate regression model showed statistical significance for five of the six dependent variables regarding prevalence of painful joints, severity of musculoskeletal symptoms and functional limitation. The regression analysis revealed that biomechanical risk factors, perceived physical environment risk factors, instrument weight and average playing hours per week, were the main predictors of PRMD. The biomechanical risk factors that predict PRMD are mainly associated with the upper limbs. A high association between PRMD and clinical observation emphasizes the need for further investigation of these risk factors and to study possible implementations in order to define 'prevention strategies' for musical routines and patterns, as used by classical musicians.
Purpose This study gives a systematic overview of the literature on the occurrence of musculoskeletal complaints in professional instrumental musicians. Methods A systematic review. Nine literature databases were searched without time limits on June 25, 2015, also the complete index of the journal Medical Problems of Performing Artists (MPPA) until June 2015 (30;2) was searched, and citation tracking and reference checking of the selected articles were performed. The search consisted of the combination of three groups of keywords: musician (e.g., musician, violin, music student, instrument player) AND musculoskeletal (e.g., musculoskeletal, tendon, shoulder, arthritis) AND epidemiology (e.g., prevalence, incidence, occurrence). Results The initial literature search strategy resulted in 1258 potentially relevant articles. Finally, 21 articles describing 5424 musicians were included in this review. Point prevalences of musculoskeletal complaints in professional musicians range between 9 and 68 %; 12-month prevalences range between 41 and 93 %; and lifetime prevalences range between 62 and 93 %. Ten out of 12 studies show a higher prevalence of musculoskeletal complaints among women. Brass instrumentalists are reported to have the lowest prevalence rates of musculoskeletal complaints. The neck and shoulders are the anatomic areas most affected; the elbows are least affected. Although some information is reported concerning age, the high risk of bias in and between these studies makes it impossible to present reliable statements with respect to this. Conclusion Musculoskeletal symptoms are highly prevalent among musicians, especially among women instrumentalists. Future research concerning the epidemiology of musculoskeletal complaints among musicians should focus on associated risk factors and follow the current guidelines to optimize scientific quality.
BMC Musculoskeletal Disorders, 2013
Background: Research comparing the frequency of musculoskeletal complaints between musicians and non-musicians is scarce. The aim of this study was to compare the prevalence of musculoskeletal complaints between musicians and non-musicians. Methods: A cross-sectional study in 3215 students from three music academies (n = 345) and one medical school (n = 2870) in The Netherlands was performed, using an electronic questionnaire. The questionnaire included socio-demographic characteristics, use of music instruments and the occurrence of musculoskeletal complaints in six body regions. Questions were related to musculoskeletal complaints over the last twelve months and at the time of the questionnaire. Chi-square, t-tests and Kruskal-Wallis tests were used for comparison between the two groups. The association between musculoskeletal complaints and possible predictors was analyzed using a logistic and Poisson regression. Results: Eighty-seven music academy students and 503 medical students returned the questionnaire, of which respectively eighty-three and 494 were included in the study. Seventy-four music academy students (89.2%) reported one or more musculoskeletal complaints during the last twelve months, compared to 384 (77.9%) medical students (p = 0.019). Moreover 52 music academy students (62.7%) and 211 medical students (42.7%) reported current musculoskeletal complaints (p = 0.001). The Odds ratio (OR) for the development of musculoskeletal complaints during the last twelve months in music academy students versus medical students is 2.33 (95% CI 1.61-3.05, p = 0.022). The OR at the time of the questionnaire is 2.25 (95% CI 1.77-2.73, p = 0.001). The total number of complaints have been modeled by employing a Poisson regression; the results show that non-musicians have on average less complaints than musicians (p = 0.01). The adjusted means are 2.90 (95% CI 2.18-3.63) and 1.83 (95% CI 1.63-2.04) respectively for musicians and non-musicians. Regarding the localization of complaints, music academy students reported more complaints concerning the right hand, wrists, left elbow, shoulders, neck, jaw and mouth in contrast to medical students. Conclusions: Musculoskeletal complaints are significantly more common among musicians compared to non-musicians, mainly due to a higher number of upper extremity complaints.
Fisioterapia em Movimento
Introduction: Musicians may present musculoskeletal pain, weakness, numbness, and tingling due to repetitive exercises. Objective: To evaluate the severity index of musculoskeletal symptoms (MS) in keyboard players. Method: A cross-sectional study including volunteers of both sexes, aged between 18 and 40 years, who performed professionally for at least 2 years, played the keyboard for at least 3 hours a week, and did not present previous history of trauma or rheumatic, neurological, and systemic diseases. The MS and its severity index were evaluated using the Nordic Musculoskeletal Questionnaire and the intensity was assessed on a scale of 4. The difference between the prevalence of musculoskeletal pain according to the anatomical region was analyzed using Fisher’s exact test. For all analyses, a significance level of 5% was adopted. This research was conducted after the ethics committee approval (No. 2,627,609). Results: Thirty-nine volunteers with discomfort were evaluated. Pain ...
Medical Problems of Performing Artists, 2017
BACKGROUND: The prevalence of musculoskeletal symptoms is high among professional musicians (73–88%). AIMS: We investigated the prevalence of musculoskeletal symptoms in Finnish symphony orchestra musicians. We compared individual instruments as well as the perceived demands of orchestral programs and difficulties in recovering after performances. METHODS: In this cross-sectional questionnaire 920 of 2,785 members of the Finnish Musicians’ Union (33%) completed the questionnaire, including 361 full-time members of symphony orchestras. Questions about pain symptoms and frequency were based on the national survey done in 2011. RESULTS: Among the 361 full-time orchestra musicians, those playing all instruments experienced frequent pain, both in the last 30 days and exceeding 30 days in the last 12 months, in their neck or upper extremities. Female musicians experienced significantly more neck (69%), elbow (31%), and wrist (30%) pain than males (neck 52%, elbow 23%, wrist 19%). The prof...
Playing-related musculoskeletal problems (PRMP) are common in adult musicians. The limited available evidence suggests PRMP are common in children and adolescents and that risk factors may be similar. The aim of this study was to determine the prevalence of PRMP in children and adolescents and their associations with female gender, age and instrument exposure. The study surveyed 731 children learning musical instruments (460 females) ranging in age from 7–17 years. Lifetime symptoms, monthly symptoms and monthly disorders (the inability to play an instrument as usual) were examined. Logistic regression evaluated the independent association of these potential risk factors with PRMP prevalences. A total of 67% students reported PRM symptoms at some point, 56% reported PRM symptoms within the last month and 30% reported an inability to play as usual within the last month. Female gender was significantly associated with PRMP (OR 1.38–1.56, p = 0.004–0.046), as was age (OR 1.19–0.23, p < 0.001). After adjustment for gender and age, type of instrument (upper and lower strings, woodwind and brass) were significantly associated with all PRMP (p < 0.005) and playing three instruments was protective against monthly symptoms (OR 0.43, p = 0.05). The study concludes that the high prevalence and disabling impact of playing-related musculoskeletal problems is clearly an important issue for child and adolescent health with gender, age and instrument exposure important factors for risk management.
BMC Research Notes
BACKGROUND: Due to ergonomic exposure musicians are at risk of work-related musculoskeletal disorders in the neck, back, and upper extremities. The literature confirms musculoskeletal problems in these anatomic regions among orchestra musicians. METHODS: An explorative cross-sectional study among 441 musicians from six Danish symphony orchestras; 216 underwent a clinical examination constructed for the purpose. Prior to the examination the musicians rated their maximally perceived trouble within the last week on a scheme blinded to the examiner. Accessibility to the clinical examination differed between orchestras.The aims were to assess the prevalence of 1) perceived symptoms within the previous week in the neck, back and limbs and of 2) clinical findings in the neck, back, and upper extremities, and 3) to investigate the co-existence of the perceived symptoms and clinical findings. RESULTS: Symptoms and findings were most common in the neck, back, and shoulders. Due to a poor co-e...
Medical Problems of Performing Artists, 2014
Most research studies investigating the prevalence of musculoskeletal disorders affecting musicians and music students have focused on classical music, while less is known about their prevalence in other music genres. The purpose of this study was to document cumulative and point prevalence of playing-related musculoskeletal disorders (PRMD) among music students in Iceland and, specifically, to identify differences between those studying classical vs rhythmic music. We hypothesized that students of classical music would report more frequent and more severe musculoskeletal disorders than students involved in rhythmic music, as classical instruments and composition typically require more demanding, sustained postures during practice and performance. A total of 74 students from two classical music schools (schools A and B) and 1 rhythmic school (school C) participated in the study by answering a questionnaire assessing PRMDs. The results showed that 62% of participants had, at some poi...
International Journal of Environmental Research and Public Health, 2020
Background: Playing-related musculoskeletal disorders are the most frequent complaints among instrumental musicians. The aims of this study were: to assess the prevalence of musculoskeletal pain; to evaluate neck, shoulder, and lower back disability; and to determine the associated factors with the presence of musculoskeletal pain among musicians. Methods: A population-based, cross-sectional descriptive study was conducted. We selected Spaniard musicians over 16 years old who played a musical instrument for at least five hours per week. They answered the Spanish versions of the Standardised Nordic Questionnaire, the Oswestry Disability Index, Neck Disability Index and Shoulder Pain and Disability Index. Results: We found 94.8% of musicians presented at least one symptomatic region in the last 12 months, and 72.3% in the last seven days. Female musicians (OR 4.38, CI 2.11−9.12), musicians with overweight or obesity (OR 5.32, CI 2.18−12.97), and musicians who play more than 14 h per w...
PloS one, 2018
Despite the high number of amateur musicians in the general population, little is known about the musculoskeletal health of amateur musicians. Playing a musical instrument is supposed to be a risk factor for the development of musculoskeletal complaints. This study aimed to evaluate playing-related musculoskeletal disorders (PRMDs) among amateur musicians playing in student orchestras. A cross-sectional study. 357 members of eleven Dutch student orchestras across the Netherlands were included in this study. A paper-based questionnaire on PRMDs was used. Sociodemographic characteristics and PRMDs were evaluated using an adaptation of the Nordic Musculoskeletal Questionnaire (NMQ) and the music module of the Disabilities of Shoulder and Hand (DASH) questionnaire. The year prevalence of PRMDs among amateur musicians was 67.8%. Female gender, younger age, higher BMI and playing a string instrument were independently associated with a higher prevalence of PRMDs. The left shoulder was aff...
2019
Introduction: Instrumentalists are exposed to numerous musculoskeletal disorders (PRMD-Playing Related Musculoskeletal Disorders) or pain (PRP-Playing Related Pain). This condition is an effect of performance requirements, numerous rehearsals and stress. Musicians often underestimate the pain and the first symptoms of the overloads that their body sends them. They usually continue to practice for many hours a day, which only enlarges the damage of tissues. Unfortunately, this approach brings them closer to disability and exclusion from their profession. Aims: Overview of the latest research on concerting musicians. Gathering information on the etiology and epidemiology of PRMD and PRP among instrumentalists. Material and methods: This overview is based on studies from PubMed, ResearchGate and Google Scholar's databases. In order to identify the relevant publications, the search was carried out using a combination of keywords: "musicians", "pain", "muscles". After applying the exclusion criteria, 16 assessed works were selected for the review. Results: The frequency of musculoskeletal disorders related to playing a musical instrument may reach 60%, up to over 80% [1,11,14,25,31-33]. The etiology of these dysfunctions should be associated with the repetitive movements of the upper limbs, either in uncomfortable positions assumed at work or in the specific posture of the body during the performance. One should also remember about the psychological aspect, which is important in understanding the mechanism of overloading and prolonged persistence of pain among musicians. An overview of the literature showed that musculoskeletal disorder concerned women more often than men. The group of instruments that were connected with more frequent occurrence of pain were violins/violas and wind instruments. The most frequently affected body areas were: neck, back, and upper limbs. The information shown above is able to speed up diagnostics as well as proper therapy for professional musicians, which will the prevention of the abovementioned disorders and the ergonomics of the musician profession. Conclusions: Professional musicians are a group particularly exposed to the occurrence of musculoskeletal disorders associated with playing an instrument, due to the specific requirements of their work. Looking at the high prevalence of these disorders, it can be concluded that the knowledge about the etiology and the prevention of overload and pain is small, and the instrumentalists themselves do not seek help from specialists. Further research in the above-discussed problem is essential to enhance prevention and ergonomics of musician profession.
PLOS ONE
Musculoskeletal (MSK) conditions among professional musicians and music students are frequent and may have significant physical and psychosocial consequences on their lives and/or on their playing abilities. The Risk of Music Students (RISMUS) research project was set up in 2018 to longitudinally identify factors associated with increased risk of playing-related musculoskeletal disorders (PRMDs) in a large sample of music students enrolled in pan-European institutions. The aim of this cross-sectional study was to describe the prevalence of playing-related musculoskeletal disorders (PRMDs) in this novel population at baseline of the RISMUS project. A further goal was to begin to identify variables that might be associated with the self-reported presence of PRMDs among music students. Eight hundred and fifty students from fifty-six conservatories and music universities in Europe completed a web-based questionnaire on lifestyle and physical activity participation levels, musical practi...
Archives of Physical Medicine and Rehabilitation, 1996
Beijani FJ, Kaye GM, Benham M. Musculoskeletal and neuromuscular conditions of instrumental musicians. Arch Phys Med Rehabil 1996;77:406-13.
BMC Musculoskeletal Disorders, 2011
Background: Musculoskeletal symptoms are common in the neck, back, and upper limbs amongst musicians. Playing-related musculoskeletal disorders have been found to range from 32% to 87% with a tendency for female musicians to have more problems than males. Studies of musculoskeletal problems in instrumentalists have generally involved pre-professional musicians or populations comprising musicians of different levels. The objective of this study was therefore to investigate the prevalence, duration and consequences of musculoskeletal symptoms in professional symphony orchestra musicians.
Journal of Bodywork and Movement Therapies, 2017
Objective: An analysis of the salient characteristics of research papers published between 1989 and 2015 that evaluate the relationship between postural quality during musical performance and various performance quality and health factors, with emphasis on musculoskeletal health variables. Methods: Searches of Medline, Scopus and Google Scholar for papers that analysed the subject of the study objective. The following MeSH descriptors were used: posture; postural balance; muscle, skeletal; task performance and analysis; back; and spine and music. A descriptive statistical analysis of their methodology (sample types, temporal design, and postural, health and other variables analysed) and findings has been made. The inclusion criterion was that the body M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 2 postural quality of the musicians during performance was included among the target study variables. Results: Forty-one relevant empirical studies were found, written in English. Comparison and analysis of their results was hampered by great disparities in measuring instruments and operationalization of variables. Conclusions: Despite the growing interest in the relationships among these variables, the empirical knowledge base still has many limitations, making rigorous comparative analysis difficult.
European Journal of Pain, 2015
General declaration: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for being included in the study.' Bulleted statements: "What's already known about this topic?" • Strong associations between sustained 'poor' posture and musculoskeletal complaints are assumed in clinical practice. • Professional musicians have an exceptional high prevalence of musculoskeletal complaints, yet they receive little attention in pain literature.
International Journal of Occupational Medicine and Environmental Health, 2014
Objectives: Musicians represent a very specific professional group, which due to some occupational hazards is exposed to different health problems known as playing-related musculoskeletal disorders (PRMDs). The aim of this study was to assess correlations between the level of physical activity, and the occurrence of musculoskeletal pain among young instrumentalists. Materials and Methods: Total of 225 Polish musical school students were investigated. To assess the study participants' physical activity level, the moderate to vigorous physical activity (MVPA) index was used. To assess pain complaints on the side of the musculoskeletal system, Nordic Musculoskeletal Questionnaire (NMQ) was applied. The NMQ questionnaire was complemented by adding a visual-analog scale (VAS), which also allowed to assess pain intensity on a numerical scale 1-10. Results: The pain localized in neck, shoulders, upper and lower back was reported significantly more often by the participants who did not meet standard criteria for the recommended or minimal physical activity level. Conclusion: Performing the recommended health-oriented physical activity may reduce the prevalence of musculoskeletal pain in young musicians.
International Journal of Human Factors and Ergonomics, 2016
String instrumentalists experience musculoskeletal symptoms that are likely associated with string playing, due to repetitive precise and delicate movements required to play the instruments. The study evaluated prevalence and associated risk factors of MSS among string instrumentalists in the Nigerian population. A cross-sectional survey design was employed to evaluate 12-month prevalence of MS symptoms using a 41-item questionnaire adapted for the Nigerian string instrumentalists, which sought information on; sociodemographic characteristics of respondents, playing history and habitual E.A. Victor et al. practices, 12-month prevalence, symptoms distribution and duration, occupational stress and performance anxiety and lastly subjective health complaints, using perceived general health status of respondents. Data were analysed using descriptive statistics of mean, frequency and percentages, while Chi-square was used to test association with alpha level set at p ˂ 0.05. The result showed a very high 12-month prevalence of 81.4% of MSS among string instrumentalists in the Nigerian population. The wrists, neck and lower back were the most affected by 75.3, 74.2 and 66.7%, respectively. It was observed that 12-month prevalence of MSS was significantly associated with the number of instruments played, carriage method, warm-up, cool-down, general life and work stress (p < 0.05), while age, years of practice and duration of playing were not significantly associated with MSS. The study showed that MSS are highly prevalent among Nigerian string instrumentalists. Thus, providing appropriate occupational/ergonomic interventions is imperative.
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